Prenatal Demonstration of Normal Variants of the Pericallosal Artery by 3D Ultrasound

Abstract

Purpose: To demonstrate the different normal variants of the fetal pericallosal artery (PCA) with the different branching forms of callosomarginal artery (CMA) by three-dimensional glass body-rendering.

Materials and Methods: With the use of the glass body mode (grey scale ultrasound and color or power Doppler), 3-D ultrasound permits precise imaging of the fetal pericallosal artery, an important anatomic landmark of the corpus callosum. This rendering mode enabled us for the first time to demonstrate sonographically the origin, course and branching pattern of the pericallosal artery with the callosomarginal artery.

Results: In 452 fetus between 18 and 41 weeks of gestation 5 variants of branching of the fetal A. callosomarginalis from the pericallosal artery were found using three-dimensional ultrasonography. The CMA was absent in 36.06 % of the 452 fetal brains studied. In 63.94 % the CMA was present and arose from four different segments of the anterior cerebral artery (ACA) from the A3 segment in 59.17 %, from the A2 segment in 20.7 %, from the A4 segment in 13.15 % and from the A1 segment in 7.61 % of the cases.

Conclusions: The use of 3-D power Doppler sonoangiography enables the precise demonstration of the normal variants of the fetal pericallosal artery with different origins of the callosomarginal artery. The knowledge of normal variants helps to detect pathological forms of the pericallosal artery.

Zusammenfassung

Ziel: Darstellung der unterschiedlichen normalen Varianten der fetalen A. pericallosa (PCA) mit den unterschiedlichen Abgängen der A. callosomarginalis (CMA) mittels 3D-Glass body-Rendering.

Material und Methode: 3D-Ultraschall gestattet mit Hilfe des Glass body-Modus (Kombination aus Grauwert- und Color-Doppler oder Power-Doppler) eine präzise Darstellung der fetalen A. pericallosa, die eine wichtige Orientierungshilfe für das Corpus callosum darstellt. Dieser Render-Modus gestattet erstmals, den Ursprung, den Verlauf und das Verzweigungsmuster der A. pericallosa und der A. callosomarginalis darzustellen.

Ergebnisse: Im Zeitraum zwischen 18 und 41 Schwangerschaftswochen konnten bei 452 Feten 5 Varianten des Abgangs der fetalen A. callosomarginalis von der A. pericallosa mittels 3D-Sonographie nachgewiesen werden. In 36,06 % der Fälle fehlte die CMA. In 63,94 % war die CMA darstellbar, wobei ihr Ursprung von 4 unterschiedlichen Segmenten der A. cerebri anterior (ACA) ausging: vom A3-Segment in 59,17 %, vom A2-Segment in 20,07 %, vom A4-Segment in 13,15 % und vom A1-Segment in 7,61 % der Fälle.

Zusammenfassung: Der Einsatz der 3D-Power Doppler-Sonoangiographie gestattet die präzise Darstellung der normalen Varianten der fetalen A. pericallosa mit den unterschiedlichen Abgängen der A. callosomarginalis. Die Kenntnis der normalen Varianten hilft, pathologische Formen der A. pericallosa zu erkennen.

Key words

Fetal A. pericallosa - A. cerebri anterior - A. callosomarginalis

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